Individual
DUSTIN MAX MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 E MARSHALL AVE, SUITE 3000, LONGVIEW, TX 75601-5500
(903) 315-2762
(903) 315-2595
Mailing address
PO BOX 4207, LONGVIEW, TX 75606-4207
(903) 315-2762
(903) 315-2595
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01060359A
IN
208600000X
Surgery Physician
Primary
N3172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00923240
RAILROAD MEDICARE
IN
Enumeration date
04/25/2006
Last updated
10/22/2025
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